BACKGROUND AND PURPOSE Many diseases, which are common in high-income countries, have an
inflammatory component. In the world's rich countries, about 10% of the population will
be diagnosed with a traditional inflammatory autoimmune disease during their lifetime. In
an autoimmune disease, the body produces auto-antibodies against the body's own protein
and the immune system destroys the body's own tissues. There are hundreds of different
types of autoimmune diseases where some of the most common are; celiac disease (gluten
intolerance), psoriasis, type 1 diabetes (T1D), multiple sclerosis, rheumatic diseases or
thyroid diseases. Diseases such as cardiovascular disease, type 2 diabetes (T2D) and
Alzheimer's disease are now also considered to have inflammatory components, and
so-called auto-antibodies have been identified that indicate autoimmunity also in these
diseases. Autoantibodies have also been identified in COVID-19 patients.
To try to understand the biology behind autoimmunity and inflammatory disease, the
investigators have analyzed the entire genome of patients with celiac disease as a model
for autoimmunity. Celiac disease is a good so-called model disease for autoimmunity
because the autoimmune reaction can be switched on and off with the help of gluten in the
diet. With a strict gluten-free diet, virtually all signs of illness disappear and the
inflammation ceases. The results from our whole genome analysis showed that genes
involved in amino acid signaling were important for disease development and pointed to
associations between celiac disease, T2D and anorexia. These results were somewhat
surprising and the investigators began to look at the role of nutritional signaling and
amino acids in inflammatory processes further.
The purpose of this study is to test whether a reduction in certain amino acids (which is
most common in wheat gluten) can improve glycemic control in healthy volunteers, parents,
as well as children, adolescents and adults with diabetes and whether levels of
inflammatory amino acids may be one of the factors behind the link between diabetes and
severe COVID-19 infection.
The participants will, for 4 weeks, eat one week as usual, eat one week wheat
gluten-free, one week wheat gluten and one week with gluten and probiotics. The
participants will be provided with continuous glucose monitors and activity-tracking
bracelets. The investigators will analyze the efficiency of glucose uptake using
continuous glucose monitors (CGM). During these four weeks, the research subjects will be
admitted for 4 clinical visits (baseline, after 1 week, 2 weeks, 3 weeks) where blood
samples will be taken. Also, during these weeks the participant will take capillary blood
samples, faeces, urine, buccal swabs and saliva at home and fill out a questionnaire
based on diet and risk factors for diabetes and questions about COVID-19.
Total number of participants: 60 Sampling occasions per participant: 15 Follow-up period
per participant: 4 weeks Number of years for inclusion: 2 years (20221201-20241201)